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Tell me all about it


Hi all 😊

I'm thinking of making the jump to school nursing.

Can you tell me about a typical day?


NutmeggeRN, BSN

Specializes in kids. Has 25 years experience.

Well...this year has been bizzare to say the very least!! Aside from C-19, we are often the only medical person in charge of 500+ people. Kids staff and visitors.

We take care of illness and injuries, with appropriate followup and documentation.

We are responsible for ensuring all children meet immunization requirements set forth by our states.

We give daily and PRN meds

We do nursing assessments, especially on our medically complex kid. Then we do treatments as needed. Gtube feeds and flushes, diabetic glucose monitoring, insulin calculation and administration. Emergency meds Epinephrine, glucagon, MDIs and nebulizers.

We sometimes teach in the classroom, but more often on every visit that comes to your door, there is an opportunity to teach.

We case manage kids who have medically complex needs, attend meetings to support Special Ed and 504 kiddos

Just to name a few

But for me, it is about relationship building, helping families at some of their most desperate times, and being that person the kids can come to.

k1p1ssk, BSN, RN

Specializes in pediatrics. Has 10 years experience.

I will literally write out a typical day!

I am in a pre-K through 6th public elementary school with an enrollment that hovers around 200 (next year we may be more like 235+ however due to a local permanent school closure).

I arrive at 8:30 and get my office set up; Kids arrive at 9.

I usually have a few kids trickle in with "presents" - clothes they borrowed, meds they need, MD notes, excuse notes, etc. Sometimes a parent with a special request.

Then, my morning med kids come in - AM stimulants and pre-gym inhaler kiddos.

Then I typically have a 15minute lull; By 9:30, I receive a list of absences that have not called to report. Sometimes I question whether or not the kiddo is actually absent, so I sometimes take a walk around the building and make sure I don't see the kid. I call those families to check in and make sure everything's OK.

Then the waiting game begins. Usually after an hour and a half, Kids start trickling in with various somatic complaints - the headaches, belly aches, nausea. It's a good time to assess nutritional deficits and find patterns. The pace of student visits picks up from around 10:30 to 1:30 as this is when the recess and lunches are happening, so there are more injuries, plus my mid-day med kids, of which there are many. Most kids are a quick assessment, some quick intervention, and back to class, but I usually have at least 1 or 2 that really need a break, or are OK to stay in school, but can't deal with going out to recess. They will hang with me and do quiet activities inside (reading, coloring, a puzzle). Some will actually nap! I think in a typical week, I probably send 2-4 kids home due to illness. Very rarely due to injury.

The last hour of the day usually drags for me. Most kids realize they are very close to the end of the day and will tough it out in class or their teachers have seen them fine all day and won't let them come to see me.

I stay until 3:15 or 3:30 depending on the day, though if a kid comes late in the day with fever, vomiting, or other exclusionary symptom, they stay with me until a parent/caregiver can come collect them, because I don't want to send them on the bus!

There are of course meetings with parents and staff, multiple screenings on every student in the school, immunization/chart auditing, and many other organizational tasks & projects. I host 2 nursing students each year for 3-4 days each. I'm sure the teachers would love for me to be in the classrooms more, but that's next to impossible with patient load.

Some important reminders to consider are that it is a very independent job, so a healthy sense/desire for autonomy is necessary! You are the major decision maker in the health of these students while they are in your care! Its a big responsibility, but a great one. Keep in touch on here if you make the leap!

Thanks both of you. I love the autonomy of my current role (home health) - it's appealing that this position has that too. 🙂

I appreciate the info! 🙂

NutmeggeRN, BSN

Specializes in kids. Has 25 years experience.

8 hours ago, RosieTheNurse said:

Thanks both of you. I love the autonomy of my current role (home health) - it's appealing that this position has that too. 🙂

I appreciate the info! 🙂

I did 5 years of Home Health Care prior to entering the school system. I think that was pivotal in my ability to work as independently as I do. Good luck!

After more scheduling frustrations at my current job, I decided to make the leap. I have an interview on Thursday 🙂 There are 2 positions that interest me. One is at my kids' elementary school (my kids are now in 5th and 8th in the fall, and we moved so my youngest will NOT be at this school but at the school for our neighborhood.) The other is for an itinerant position. It's a very large district and I'd be at all the different levels I think filling in. I'll find out more on Thursday, but I'm kind of torn. The elementary job - I already know and love many of the staff, including the principle and the social worker (love, love him!). The other would be floating which might be nice to see the different age groups and have a change in scenery.

I'm really excited about the interview, and the schedule that will never stress me out r/t the kids being home alone when I'm working.

Any tips for the interview? (I bought a book to read beforehand. It's a quick guide reference for school nurses.)

laflaca, BSN, RN

Specializes in School Nursing. Has 7 years experience.

The things that freak principals out are: 1) medical emergencies or any sight of body fluids, 2) social/emotional, drug abuse, or mental health issues when they can't get a social worker, and 3) unhappy parents. So the questions often focus on those topics - what if a parent insists by phone that you give a med when you don't have the right paperwork/prescription, what will you do if a kid seems depressed/suicidal, how would you proceed if a kid reveals that dad hit him, what's your experience responding to diabetic or allergic emergencies, what if a kid seems high, etc.

They might want to know if you understand the basics of IEPs and 504 plans - you probably don't need to be a pro, just know what they're talking about. They might ask about your experience with common school-nurse stuff (diabetes, epipens, asthma, vaccination schedules, seizures, other chronic conditions seen in peds). They will probably ask some of the usual general interview questions too...why do you want the job, what are your strengths.

Or, they might not ask you much at all. I've done a few school nurse interviews over the last few months, and each one was different.

Also, ask some questions of them! My favorites are

  • What do you value most about the school nurse's work? Why is it important to have a nurse on campus ?" (the answer may tell you everything you need to know about your future relationship with that principal, for better or worse. Their idea of what's important can be surprising).
  • What have past nurses said was most challenging and most rewarding about working here?
  • What is your setup for covering lunch/days off for the nurse? (another revealing one, ha).
  • If I were hired, who would be my go-to people for common tasks/questions/information that nurses need?
  • Who supervises the nurse? (it varies). If the person is present: I know it can be a challenge to supervise someone in a different profession from your own. Can you tell me a little bit about your approach?

If you get the luxury of a choice, I'd lean toward the position at your current elementary school. The first year is a big, weird learning curve, and it might be easier to do it staying in one place.

Good luck!!

WOW!, THANK YOU for all your advice! I truly appreciate it!

I am leaning towards the elementary school I know for several reasons, but you bring up a great point. I'm starting over. It would be nice to at least be in terrain I'm familiar with.

I'll study up on those questions you mentioned (I bought a book, and do some internet reading).

Thank you, again!😊😊😊

I accepted a job at my kids old elementary school! I'm so excited! 😄

Thank you all for you input, tips and time! 🙂

I'm looking forward to taking on this new adventure! 😄

BrisketRN, BSN, RN

Has 4 years experience.

On 5/11/2020 at 5:23 AM, NutmeggeRN said:

I did 5 years of Home Health Care prior to entering the school system. I think that was pivotal in my ability to work as independently as I do. Good luck!

I also have a background in home health/private duty. Feeling comfortable on your own is huge. Knowing your resources is huge. Thinking on your feet is huge. @RosieTheNurse you'll do great. Crazy school year you'll be starting in, but you certainly won't be bored.